Tribunal decision ‘could deter companies from building more institutions’

A tribunal’s decision that a care provider should not be allowed to build a new residential home because it would look “institutional” and too much like a hospital has been welcomed by autistic rights campaigners and a leading self-advocacy organisation.

The tribunal ruled (pdf) in favour of the Care Quality Commission’s (CQC) decision to refuse an application for the new facility in Walsall on the site of a former NHS campus, submitted by Lifeways Community Care and backed by Walsall council.

CQC decided last year to block the development – of ensuite bedrooms and three self-contained flats for nine autistic people and people with learning difficulties, with some communal facilities – because it would produce a “campus”-type setting.

National guidance says campus-style or congregate services* are not in the best interests of people with learning difficulties and autistic people and do not promote their right to choice, independence and inclusion.

Lifeways already has six supported living flats on the site in Spring Lane, and CQC argued that the new service would be too big and would not promote integration with the local community.

CQC told the tribunal that the proposed service was “not small-scale, is not domestic in style and is clearly different to the houses in the local area” and had the “appearance of a care facility, not of typical housing”, with “some features of a campus.”

It added: “The outcomes of this service model have been demonstrated to be less good for people with learning disabilities than is a model based on people with learning disabilities living in the same sort of ordinary places as everyone else.”

But the development was supported by Walsall council, whose lead commissioner Ian Staples told the tribunal that he was “under pressure to get people out of hospital”.

He accepted that he was taking “a professional risk by supporting something that doesn’t toe the line”.

Staples told the tribunal: “I accept [it] is bigger than six beds and there is a risk.

“Ideally we would look at six, but I had 12 to 15 people looking for places and I didn’t have other sites available, so I made an informed decision and looked at the risks.”

But the health, education and social care first-tier tribunal unanimously decided that it was “obvious the proposed care home had an institutional look to it and clearly had characteristics of a campus style setting which stood out and was apart from the surrounding neighbourhood”, and that it was “completely inappropriate”.

The tribunal also said the development would create “unacceptable and serious risks to service users in the provision of care”.

Kat Humble, communications officer for Autistic UK, which is run by and for autistic people, welcomed the tribunal ruling.

She said: “Autistic advocates and allies have been campaigning for decades to stop the segregation of autistic and learning disabled people away from their larger communities.

“It is disheartening to see that these sorts of institutions are still in operation in some places and that care companies still attempt to open them because they are more profitable.

“However, we at Autistic UK anticipate that the CQC’s firm stance on denying applications for these places will deter companies from attempting to build them in the first place.

“Isolating people from their communities is inhumane treatment and violates our right to live full and happy lives, whatever level of support any individual requires.

“Living in our larger communities is the first and critical step to being accepted and fully included.”

Andrew Lee (pictured), director of policy and campaigns at People First (Self Advocacy), also welcomed the CQC stance and the tribunal’s “important decision”.

He said: “Institutions have no place in independent living in the 21st century.

“These kinds of institutions prevent access to living, choice, control and independence and this gives a strong message to care providers about what is not acceptable.

“It is these kinds of high-profile decisions that help to put the UN Convention on the Rights of Persons with Disabilities into practice.

“It says that being locked up and excluded from society is not supported by the CQC.

“Now what we need, moving forward, is to see commissioners and local authority decision makers getting on board with this approach to meeting the care and support needs of people with learning difficulties.”

CQC said it was an “important judgement” because it “further clarifies what is an acceptable care setting”.

Lifeways confirmed that it would not appeal the tribunal’s decision.

A Lifeways spokesperson refused to say if it would stop building such settings for disabled people, and why it attempted to open such a service when it would breach both the UN Convention on the Rights of Persons with Disabilities and national guidance.

But he said in a statement: “Lifeways are disappointed by the tribunal decision, as we felt strongly that the homes we are providing are of a high standard, meet the needs of local people, and also meet the principles of Registering the Right Support [the CQC guidance], principles that we support.

“The homes were developed in close collaboration with the local authority, who are clear that they meet the needs of the people in the borough.

“We will continue to work with both commissioners and the CQC to ensure that future developments are of a high quality and meet the needs of the people we support.”

A Walsall council spokesperson said: “After being fully engaged by Lifeways in the development of their plans, Walsall council did not consider the application to be for an ‘institutional-type’ setting and therefore not contrary to national guidance.”

“Walsall currently has over 84 per cent of adults with learning disabilities in receipt of a care package living with family or in their own homes, which is well above the national average.

“The application by Lifeways was in response to local need, a nine bed registration presented as two three bed bungalows and three flats with some communal areas.

“For some individuals, on their journey to their own accommodation, a period of living with others can be beneficial and taken in a local context is reasonable and in line with the Care Act requirement of providing choice and a range of provision.”

*CQC guidance (pdf) defines campuses as “group homes clustered together on the same site and usually sharing staff and some facilities”, and congregate settings as “separate from communities and without access to the options, choices, dignity and independence that most people take for granted in their lives”

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